There’s no shortage of horrifying stories about flesh-eating bacteria (also known as necrotizing fasciitis), but this one will really make you shudder.

As documented in a new report published in the South African Medical Journal, doctors at Grey’s Hospital in South Africa have treated 44 patients in five years who all mysteriously have the same condition: flesh-eating bacteria on their junk.

What is Fournier gangrene?

Fournier gangrene is a form of the necrotizing bacterial infection that affects soft tissue in the genitals. Your scrotum has plenty of small crevices that trap bacteria, which makes it easy to get an infection, as MensHealth.com has previously reported. Women may also develop Fournier gangrene, though it’s much less common.

The summer seems to be associated with an uptick in necrotizing fasciitis stories, since one form of bacteria that causes the condition, vibrio vulnificus, is more prevalent in ocean waters during the summer months, LiveScience reported.

How common is Fournier gangrene?

Estimates are rough, but research has shown that there’s about 1.6 Fournier’s gangrene cases per 100,000 males each year, making the condition extremely rare.

What causes Fournier gangrene?

To develop Fournier gangrene, someone would need to develop an infection caused by very specific strains of bacteria in the urinary tract, or via cuts and/or abrasions in a guy’s scrotum or perineum (the space between your scrotum and anus). There’s one case report of Fournier’s gangrene developing in a 29-year-old male whose excessive masturbation habits led to abrasions on his penis, which led to an infection. But as as the doctors in the paper note, his condition is very "unexpected." (Don’t worry, guys – masturbation is still good for you.)

Dr. Brian Steixner, M.D., Director of the Institute of Men’s Health at Jersey Urology Group in Atlantic City, says he’s treated multiple patients in his own practice. Sometimes, he says, guys get Fournier gangrene after cutting themselves while manscaping.

“It can start with a nick to a hair follicle during shaving,” he previously explained to MensHealth.com. “A very specific bacteria gets under the skin, and it travels fast. It basically starts to eat away at all the skin."

What are the symptoms of Fournier gangrene?

The early signs of necrotizing fasciitis start within 24 hours of the infection and symptoms get more severe within three to five days.

Patients will first experience pain and tenderness in their genitals, according to a case report published in the Journal of Cutaneous and Aesthetic Surgery. They’ll also become feverish and lethargic, which can last for two days to a week. As the condition worsens, the affected area will become swollen, and pain and tenderness will get worse. Red or blueish purple patches will appear on the skin.

In men, the scrotum can be destroyed to leave the testes exposed. Dying tissue may extend beyond the genitals to the thighs, stomach and chest.

How is Fournier gangrene treated?

The condition spreads quickly, so it’s important to see a doctor who can take a tissue sample to determine if you have Fournier gangrene. Antibiotics are given to treat the bacterial infection and surgery is performed to remove dead skin tissue.

In some instances, damaged skin may need to be restored through reconstructive surgery. Severe damage to the penis or anus may require the lifelong use of a catheter to remove urine. Patients may also need to receive pure oxygen, known as hyperbaric oxygen therapy, to kill bacteria.

Fatality is high, and about 20 to 30 percent of those impacted die from the condition.

How is Fournier gangrene prevented?

The best way to prevent Fournier gangrene is to wash and keep open wounds clean until they heal. Case reports have shown that the condition is more common in people who have weaker immune systems, like the elderly or people with diabetes. If you have any cuts or wounds on your genitals, it goes without saying that they should be treated immediately.

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